利多卡因联合甲基强的松龙鼓室内注射治疗难治性突聋

目的:研究利多卡因联合甲基强的松龙鼓室内注射治疗难治性突发性耳聋的有效性及安全性。方法:选取耳鼻咽喉头颈外科住院治疗经规范常规全身用药治疗2周后无效的突发性耳聋25例,经耳内镜行利多卡因联合甲基强的松龙鼓室内注射治疗,每周2次,2周为1个疗程。治疗结束后复查纯音听阈测听及检查鼓膜情况,听力疗效评价采用平均听阈(PTA)下降≥15 dB为有效。结果:25例患者中,治疗有效的患者为8例,有效率为32%。比较治疗前后纯音听阈情况,500、1 kHz、2 kHz听阈下降明显,差异有统计学意义(P<0.05)。结论:利多卡因联合甲基强的松龙鼓室内注射是治疗难治性突发性耳聋的一种有效且安全的方法。

A study of transtympanic lidocaine and methylprednisolone injection for refractory sudden sensorineural hearing loss

Objective To evaluate the efficacy and safety of transtympanic lidocaine and methylprednisolone injection for refractory sudden sensorineural hearing loss.Method Studied were 25 patients who had received transtympanic lidocaine and methylprednisolone injection after having failed with intravenous steroids and other medications from Aug 2008 to Mar 2012.They all had received intravenous dexamethasone and other medicatio ns for two weeks and no improvement of hearing.The transtympanic lidocaine and methylprednisolone injections were administered with oto-endoscope twice a week for 2 weeks.Hearing and tympanic membrane were monitered one month after the termination of injectio ns.Hearing improvement was defined as more than 15 dB in pure tone average （PTA） .Results 8 patients had improvement of hearing （32%） according to the PTA.The thresholds of 500,1 000 and 2 000 Hz decreased obviously （P〈0.05） .Conclusion Transtympanic lidocaine and methylprednisolone injection can be considered as a salvage treatment for refractory sudden sensorineural hearing loss.